UCLALive
ticketsevents
visitabout
educationsupport
support main pict
Design for Sharing Membership Form
(Download a PDF that you can fax or mail)

*indicates required field
Title
*First Name:
*Last Name:
*e-mail Address:
*Home Address:
*City:
*State:
*Zip Code:
*Home Telephone:
Work Address:
City:
State:
Zip Code:
Work Telephone:
Please send mail to my business address (home address used by default)
*Please Enroll Me at the Support Level Checked Below:
$60 PATRON (fully tax-deductible)
$100 SPONSOR (fully tax-deductible)
$250 STERLING SPONSOR ($200 tax-deductible)
$500 BENEFACTOR ($450 tax-deductible)
$750 ADVOCATE ($700 tax-deductible)
$1,000 DISTINGUISHED BENEFACTOR
($950 tax-deductible)
$2,500 STERLING BENEFACTOR
($2360 tax-deductible)
$5,000 PRESIDENT'S FORUM
($4632 tax-deductible)
$10,000 and above CIRCLE OF MUSES
($9632 tax-deductible)
Other amount $  
(If you are unable to join at this time, gifts of any amount are welcomed, encouraged, and are fully tax-deductible.)
I want my gift to be fully tax-deductible and do not wish to receive ticket or parking benefits.
Check here if you would like your gift to be anonymous.
Name as you would like it to appear in public recognition:

Check here if your employer or organization has a matching gift program and provide your employers name

*Payment Type
*Credit Card No.:
*Expiration Date:
   
How did you find out about us?
Friend
Web Site
Central Ticket Office
Brochure
Publications - If so, please list here:
Other:


Membership year: July 1 through June 30.

For more information about Design for Sharing, please contact us.

Tel 310.825.7681
Fax 310.206.3843

Email:
dfs@arts.ucla.edu

Mailing Address:
Design for Sharing
UCLA Performing Arts
B100 Royce Hall
Box 951529
Los Angeles, CA 90095-1529